Provider Demographics
NPI:1013242916
Name:MORTENSON, FRANCIS NEAL (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:NEAL
Last Name:MORTENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 FOX FARM RD
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4807
Mailing Address - Country:US
Mailing Address - Phone:435-753-0870
Mailing Address - Fax:435-753-0870
Practice Address - Street 1:1141 FOX FARM RD
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4807
Practice Address - Country:US
Practice Address - Phone:435-753-0870
Practice Address - Fax:435-753-0870
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT146448-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology